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Managing atrial fibrillation: An update

New guidelines provide advice on the role of drugs, weight loss, and procedures to cope with this common heart rhythm disorder.

The classic symptom of atrial fibrillation — a fluttering or thumping sensation in the chest — can leave you breathless, dizzy, and tired. Caused by electrical misfires in the heart's upper chambers (atria), this condition affects an estimated one in 11 people ages 65 and older.

While the symptoms of atrial fibrillation (often called afib) can be unsettling, the real danger is a heightened risk of serious strokes (see "How afib can lead to a stroke"). As many as 30% of strokes from afib prove fatal, notes Dr. Christian Ruff, a cardiologist at Harvard-affiliated Brigham and Women's Hospital.

Shortness of breath: A common symptom with many possible causes

Heart and lung issues are often to blame for breathlessness. But an accurate diagnosis may require advanced testing.

Like your heartbeat, the regular inhale and exhale of your breathing is something you usually don't notice — until something doesn't feel quite right. Shortness of breath can result from a range of problems, including an allergic reaction, an anxiety attack, or anemia. But most often, the underlying cause is a heart or lung condition.

"Because these two organ systems are so intertwined, one always affects the other," says Dr. Aaron B. Waxman, who directs the Pulmonary Vascular Disease Program at Harvard-affiliated Brigham and Women's Hospital. In fact, about 60% of people with heart disease also have a lung disease. As a result, it's not always easy to distinguish cardiac and pulmonary issues, he says.

Newer breast screening technology may spot more cancers

Digital breast tomosynthesis may also reduce the number of unnecessary and nerve-racking callbacks for additional testing.

If you're in your 40s, you may want to consider switching from digital mammography to digital breast tomosynthesis (DBT) for your next breast cancer screening, say the authors of a study published online February 28 by JAMA Oncology.

A review of more than 170,000 screening mammograms using the two technologies determined that DBT — sometimes referred to as 3D mammography — did a better job at accurately detecting cancers in women of all ages. The advantages were most pronounced for women in their 40s. DBT was also better at finding cancers in women with high breast density, which can make cancers more difficult to spot on screening exams. High density indicates a larger proportion of active tissue in the breast and is a risk factor for breast cancer.

Platelet-rich plasma therapy may help counter balding

Research we're watching

If your hair has been thinning, an infusion of your body's own plasma may help grow it back, according to the American Academy of Dermatology.

A number of recent studies show that platelet-rich plasma (PRP) therapy is successfully regrowing lost hair. This includes a 2018 study in the International Journal of Women's Dermatology that found the technique was beneficial in treating androgenetic alopecia, a type of genetically and hormonally driven hair loss that affects as many as 35% of women by age 60.

Four keys to prevent cardiovascular disease

Are you doing everything you can to keep your heart healthy?

After decades of steady decline, the number of deaths from cardiovascular disease (CVD) has risen over the past few years, according to the American Heart Association.

The good news is that an estimated 80% of all CVD cases — heart disease, heart attack, heart failure, and stroke — can be prevented. The key is to control high blood pressure and high cholesterol and to maintain healthy habits, such as exercising regularly, eating a plant-based diet, getting enough sleep, and not smoking.

Skipping a beat — the surprise of heart palpitations

Interesting heart palpitations causes and treatment for a case of the heart flutters

Does your heart unexpectedly start to race or pound, or feel like it keeps skipping beats? These sensations are called heart palpitations. For most people, heart palpitations are a once-in-a-blue-moon occurrence. Others have dozens of these heart flutters a day, sometimes so strong that they feel like a heart attack.

Most palpitations are caused by a harmless hiccup in the heart's rhythm. A few reflect a problem in the heart or elsewhere in the body.

Biotin may throw off lab test results

 

News briefs

A warning for people who take the dietary supplement biotin (vitamin B7): the FDA says taking too much of the vitamin may interfere with the results of some lab tests. Biotin is often included in multivitamins, prenatal vitamins, and dietary supplements marketed to improve nails, hair, and skin. While there's no recommended dietary allowance established for biotin, the adequate intake value is 30 micrograms per day for people ages 19 or older and for pregnant teens and women. But biotin supplements may contain up to 650 times the adequate intake. The FDA warns that taking too much biotin can interfere with lab tests, such as hormone tests and tests for markers of heart attacks (like troponin). An inaccurate lab result can have dangerous consequences. For example, the FDA reports that one person taking high levels of biotin died after a falsely low troponin test result. The FDA also notes it's seeing an increase in reports of biotin interference in lab work. The bottom line: Always tell your doctor which supplements you're taking. And remember, most people can get enough biotin from a healthy diet that includes seeds, nuts, meat, fish, eggs, and certain vegetables (such as spinach and broccoli).

Angioplasty without overnight hospital stay is safe and saves money

Research we're watching

Going home the same day after having an angioplasty not only is safe, it may save the health care system an average of more than $5,000 per person, a new study reports.

Every year, some 600,000 people in the United States undergo coronary angioplasty, a minimally invasive procedure to open a narrowed heart artery. About half are so-called elective angioplasties, which are done on people with predictable but worrisome chest pain (stable angina).

Understanding ejection fraction

Ask the doctor

Q. My doctor wants to measure my ejection fraction. What does that mean, and what should I expect?

A. With every heartbeat, your heart contracts and relaxes. During the contraction, the heart's main pumping chamber, the left ventricle, ejects blood out to the rest of the body. When your heart relaxes, the ventricle refills with blood. The ejection fraction is the percentage of blood leaving the chamber each time it contracts.

Detecting afib with a smartphone camera?

Research we're watching

Picture this: One day, you may be able to use your smartphone camera to detect atrial fibrillation. Also known as afib, the irregular heart rhythm raises the risk of stroke. New research suggests that the technique, which relies on a special app, is almost as accurate as an FDA-approved mobile electrocardiogram.

Here's how it works: You place your index finger on the smartphone camera, which uses the camera's light to detect changes in your pulse. The app algorithm then uses that information to determine whether your pulse is steady and regular (normal rhythm) or fast and irregular (afib).

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